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Thread: Renal US ?

  1. #1
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    Default Renal US ?

    Is is correct coding to bill a complete Renal Ultrasound ( 76770) with just kidneys and bladder documented, hx/clinical is “Flank Pain”?


    Thanks:-)

    Kimberley Tober, CPC
    Franklin, TN

  2. #2
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    Any info/reponses to my question would be greatly appreciated:-)

    Thanks so much

    Kimberley Tober, CPC
    Franklin, TN

  3. #3
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    Default

    Does anyone know the answer to my question?

  4. #4
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    Default 76770

    Quote Originally Posted by Kimberley View Post
    Is is correct coding to bill a complete Renal Ultrasound ( 76770) with just kidneys and bladder documented, hx/clinical is “Flank Pain”?


    Thanks:-)

    Kimberley Tober, CPC
    Franklin, TN
    Here's what CPT assistant has to say:

    Ultrasound of bladder, kidneys and ureters
    CPT Assistant, May 1999 Page: 10 Category:
    Note from 3M:
    As of January 1, 2007
    Ÿ 76536, 76604, 76645, 76700, 76770, 76856 and 76880 have been revised. They no longer include B-scan.


    Diagnostic Ultrasound

    Question

    What are the appropriate CPT codes to report ultrasound of the bladder, ultrasound of the kidney, and ultrasound study of the bladder, kidneys and ureters?

    AMA Comment

    You should report CPT code 76775, Echography, retroperitoneal (eg, renal, aorta, nodes), B-scan and/or real time with image documentation; limited, if an ultrasound examination of a single organ (eg, kidney or urinary bladder) is performed. CPT code 76770, Echography, retroperitoneal (eg, renal, aorta, nodes), B-scan and/or real time with image documentation; complete, would be reported if a complete ultrasound examination of the urinary tract (eg, kidneys, ureters, and urinary bladder) is performed.




    CPT Assistant © Copyright 1990–2009 American Medical Association. All Rights Reserved

    So, unless all areas are performed, I wouldn't code the 76770. I would use the 76775, it's listed as: ultrasound, retroperitoneal; limited.
    According to CPT "A complete ultrasound examination of the retroperitoneum (76770) consists of real time scans of the kidneys, abdominal aorta, common iliac artery origins, and inferior vena cava, including any demonstrated retroperitoneal abnormality."

    Anyone else?

  5. #5
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    Default

    Any more comments on my question....still have controversy going on at work. Thanks!!!

  6. #6
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    Default Per ACR

    According to the ACR...

    "How should an order for an ultrasound of the kidneys be performed and coded? Unless the referring physician specifically asks for a renal size assessment only, we evaluate for an intrarenal or postrenal cause of the patient’s symptoms. Our standard scanning protocol involves images of the kidneys and bladder and often evaluation for ureteral jets within the bladder. This leads me to believe, therefore, that we should actually bill for a complete retroperitoneal ultrasound.


    Radiologists should always tailor their examinations on the basis of the clinical information received, and services should be coded on the basis of both medical necessity and the details of the examination performed.


    According to Current Procedural Terminology® (CPT) guidelines, p. 248 of the standard version of the CPT code book: A complete ultrasound examination of the retroperitoneum (76770) consists of real-time scans of the kidneys, abdominal aorta, common iliac artery origins, and inferior vena cava, including any demonstrated retroperitoneal abnormality. Alternatively, if clinical history suggests urinary tract pathology, complete evaluation of the kidneys and urinary bladder also comprises a complete retroperitoneal ultrasound.
    Therefore, if only the kidneys are medically indicated and evaluated, then a limited retroperitoneal code, 76775, should be reported."

    http://www.acr.org/Hidden/Economics/...aspx?css=print

    Hope that helps!
    Jessica O'Donnell CPC

  7. #7
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    Default Renal US

    If clinical indication/history states 'FLANK PAIN'....does this justify being examined for a uninary tract problem? therefore being able to bill a complete 76770 if the kidneys and urinary bladder are documented?

    Thanks.

    Kimberley Tober, CPC
    Franklin, TN

  8. #8

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    It does by virtue of the kidneys being in the flank area and the kidneys are directly involved in the urinary tract...ever feel like you're playing "here we go round the maypo" with coding?

    Have a great day

    Joyce

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